Tibial Plateau Fracture Recovery

[lobrien98]

I am approaching my 3rd anniversary of my tibial plateau fracture. I have 2 plate, 7 screws and a graft for repair. I still have swelling on a regular basis and minor pain most days. I feel weather changes like never before and feel like I have aged 25 yrs....I am only 35 but move slower than a 60 yr old. I am wondering if this is normal at this point or if I need to revisit my Dr. I have the muscle mass I did before...it took 2yrs to get it all back but its there.

[skiplct]

Any comments/observations about using a NuStep recumbent cross trainer during rehab instead of stationary bike? I have access to former but not the latter.

Also- to those who are 1+ year from injury: Please post at approximately what point you felt you achieved as much recovery as you were ever going to get. Six months/9 months/1 year/more? I know it is very dependent on age, severity of fx, and surgeon but I'm interested in benchmarks.

[Casper2012]

Lobrian98 . You don't say exactly where your pain is but I would suggest a visit to your Ortho and ask about whether the hardware should be removed. Seems like it can cause a lot of issues for some people.

[skiplct]

I agree w/Casper, maybe hardware removal--- at least some of it-- would help. My doc plans to remove 1 of my plates in one year but prob. leave the other plates and screws in.

[dnabike]

Got into a pool for the first time yesterday. If you can get to one please do. You need one with a handicap chair to lower you into the pool and water that varies from shoulder deep to waste deep. You can also exercise in the deep end with a floatation device. Being able to walk with a normal gate (although it took shoulder deep water) was great. Practiced raising up on my toes and had all kinds of cracking and popping in my ankle which is good, means the ankle is settling in. You can just do a lot of things you can’t do on land. If you can’t get deep enough just use a float belt to take extra weight off.

I’m 166 days from my fall and 19 days from my next x-rays and hopefully FWB status. If that goes as planned my therapist and I have set a goal of walking normally (without walker) in 34 days. I will be adding the pool to my exercise regimen at least 3 times a week. I will just keep walking in less and less water, until I don’t need the pool.

Good luck to everyone.

[dnabike]

For those that have not seen external fixation. They drill 4 holes in your leg to attach. It maintains the correct length and orientation of your leg.

[skiplct]

Wow dnabike Congratulations! -- Fantastic progress. I've heard raves abt pools on this message board. Wish I could try it! The 2 pools near me won't allow anyone in unless they can enter and exit the pool unassisted. That ain't me.. Can't go w/o crutches or walker and couldn't drive myself there anyway since my car is a standard trans and it's my left leg that's busted in 4 places including tpfx. I'm gimping around the kitchen now but can't do FWB for more than 2 or 3 steps. Still have to make dinner for kid and pets though... Haven't set any specific goals for normal walking as I have heard that for fx this serious-- a "new normal" emerges and I don't know what that will be yet so I'm trying to just stay focused on 1 day at a time. Post when you walk across a room! Best wishes.

[c3neely]

Tibial Plateau Fracture March 2011 in a Brazilian Jiujitsu injury...Plate and 6 screws to fixate lateral Tibial plateau that was "in pieces." May 30th this year I got my hardware out, partial meniscus removal, and microfracture for an area on the top of my tibia with no cartilage left.


I wish I could say im doing good with it...but mentally im having a hard time with it. Im 28, and was extremely active before this...the hardest part is theres not a lot of examples of people out there who have had this done, and u can look at them now and say "oh they are doing fine...so ill be ok"

Alice Mckennis is a skiier that had the same injury, got her metal out, and is back on the slopes competing at a high level...but thats pretty much it athlete wise. I dont even care about being an athlete again, i just want to get to the point where I can walk around all day at work, and not think about my knee every single step that I take. It feels like its giving out...i have no strength in my ankle/calf...im starting to run out of money, and need to find a job in the next 2 months...i have no idea what to do

Im going to keep fighting, because I dont have a choice...i just wish i had torn my ACL, or MCL...or all of my ligaments...bcause there are clear cut example of people like that who, through hard work, got back to some form of their old selves

This injury, it definitely seems like "u can work hard...but ure going to need a knee replacement in a few years anyway...and the more u do on it now, the sooner ure going to need to get that done"


I dunno guys, im just not doing good with this...trying to keep high spirits, but its hard

[groycan]

Hey,
I suffered a tibial plateau fracture on March 3, 2012 in a soccer game. I had surgery and had nine screws and a plate inserted. Bed rest for eight weeks and then worked on bending of the leg. Was able to lift the leg around July. Problem is that it is still extremely painful and I cannot, from my leg being bent in a 90 degree position straighten my leg from the knee down. When I try to lift my ankle you can see my muscles work but nothing happens... wanted to know if anyone else has experienced this. I had an MRI and those results came back with no ligament damage. I have seen 3 doctors, 2 of whom call me a medical mystery- GREAT!
Second question is has anyone seen mental help for their injury. As much as I would like to think my injury has not effected me, it has- both in my home life and work life...
Thanks!

[didevro]

On July 20th 2012, I fractured my tibial plateau in a skiing accident, right at the end of a long day on the slopes. Initial xray showed comminuted fractures, with suspicion of ligament damage. I was put in a zimmer frame and handed a set of crutches.
When I got to see surgeon on August 8, he looked a my MRI pics, shook his head and said "Very interesting knee, facinating knee". He discovered that I had old (more than 6 years) fractures of my tibial plateau, which hadn't healed properly (I had no idea it had been broken, had been to a doctor before with painful knee, but they never xrayed), and new fractures.
And he found that I had destroyed my ACL, PCL, and MCL. He told me that he would first repair the ligaments, and do a second operation (through the back of the knee) to pin the bones, after the ligaments repairs healed. So on August 13th I had a 3 hour operation to repair ligaments using artificial ligaments plus my hamstring ligament. While he was operating, my surgeon discovered that he could actually get a couple of screws in to the fracture from the front.
So I went home, hoping that the screws would hold. No weight bearing, on crutches (I hate those things), I soon discovered it was much easier and safer to push myself around my house on my office chair. My car is a manual, so I had to rely on others for transport, or borrow an automatic. Ended up buying a small folding wheelchair, much easier for shopping, and you can carry stuff.
Last week Oct.25th I went back to see my surgeon. He looked at my CT scans, shook his head and said 'interesting knee, facinating knee', (I think he enjoys challenges) and told me I could carefully weight bear around my house, but outside on crutches and only 50% . Then he said that the small fracture was sitting loose, encased in fibrous tissue at back of knee, and the large fracture, which starts just under my ACL attachment point, has just tack welded at the top. What joy!! Not.

I see him again in a month, and looks like the operation through the back of the knee is going to be necessary after all. Oh, expletive, expletive, expeltive! The weight bearing should help to build a bit more bone, I hope. This is turning out to be a long, long road.

[skiplct]

Recap of my stats:

TPFx, complete mid-shaft fx and fib fx 8/2/12. Bicycling accident.
Surgery 8/8/12, 3 plates & 12 screws.
PWB at 8 weeks, still PWB except for a few TWB steps around kitchen.
58 y/o, single mom of 1 teen daughter, a German shepherd and 2 cats.
Not much in the way of social support structure.
No health insurance; was long term unemployed before accident.
Was extremely active before accident; jogged 10k/day for past 35 years plus daily bicycling,
gardening, frequent hiking, tennis.

Going to PT 2x/week and doing some stretches at home, some use of NuStep recumbent crosstrainer.

Was told flatly that I was lucky to have kept the leg at all and that I'd never jog again
like I used to. Might walk w/permanent limp. and or/cane.

As bad as the physical pain has been, it pales in comparison to the mental/emotional suffering
this injury inflicts. To recent posters c3neely, groycan, didevro-- please know that you
are not alone on this point. c3neely-- I congratulate you on the progress you've made even
to be walking around at all w/o crutches or walker, and that you have a job to walk around at.
All that is still a distant goal for me. Groycan-- I don't have the $$ for counseling but would do it if I could-- this thing is a tsunami to the morale and psyche. Didevro-- my car's a manual trans too and I broke the left leg so I too haven't driven since Aug1. It's pretty scary to be a single mom living in a house w/ a kid-- she is doing all she can to help but has school work too and can't drive, pay bills, etc. No drivers in the house in case of an emergency. . I too found the wheelchair helpful in being about to retrieve and carry things. Also use a walker w/a bicycle basket strapped to te front for carrying.
Had an appt scheduled in NYC tmow morning for a 2nd opinion but had to cancel of course because of the storm.

This is a life-changing event-- no doubt about that. My future is suddenly completely different than I had imagined it up until Aug 2. But on the days when I go to PT and the table next to me has a double amputee, the table behind me has a single amputee and the table in front of me has a stroke victim or a Parkinson's patient.... I imagine their futures are pretty altered from what they once envisioned too. Cherish whatever you can, while you can.

[tashikofreako]

I fell about 8 feet out of my lofted room on september 15th, landed hard on my left foot and ended up with a displaced medial tibial plateau fracture (type IV) and an acl avulsion tear. I had my surgery September 21 and boy has it been a crazy time. I'm only 22 and just graduated college so this has sure slowed me down quite a bit, I was supposed to leave soon go to South America for 8 months. Luckily I didn't need to have any grafts or cadaver tissues used. Reading this forum sure isn't helping...it seems almost no one fully recovers from this...and there are very few people with medial fractures. Well I thought I'd share some pictures...it would be nice if more people would!

right after surgery

It is looking a lot better now but still swollen. My calf had had a lot of issues as well. I didn't have compartment syndrome but my muscle has been very swollen and stiff, I am only now beginning to be able to move my ankle a bit, before it was stuck at an odd angle. I am also having a lot of hip pain which feels a bit like sciatic pain. I'm 6 weeks from the surgery and can bend my knee about 80 degrees which apparently is very good. I should be starting outpatient rehab soon and hopefully beginning the weight baring process. I would really appreciate any responses from anyone who has experienced some of the same things as me!

[smilybeck]

Date of Injury: 11th August 2012
Date of Surgery: 28th August 2012 - had to wait until the swelling came down (required hospital stay)
Injury: Fractured left Tibial Plateau while running, tripped over some bricks and heard it pop. I'm 32 years old and have no idea how I did that. Neither do the Drs, OS or PT.
It's now held together with K wires, screws and plate.
NWB: 6 weeks
PWB: Start of my 3rd week...starting to swap over to one crutch
Range went from 78 degrees at the end of 6 weeks to 103 last night (after my PT session 113).
Started Work: Back at work 2 weeks in the NWB - love my job, needed company.

Well, it's been an interesting life experience. I have never broken a bone before, had surgery, ride in the ambulance or had a hospital stay. All I can think of at least it's not worse and it's only a broken leg - however it's been so hard. Especially since I'm an independant creature by nature (the nurses found that difficult), have been enjoying exercising. I was training for a tri so I could bet the guys at my work next year. My husband has been doing everything for me, however he's stressed out from work deadlines. I'm usually such a happy, social person...I've never been this depressed in my entire life.

Last week was hard. Have been having nerve issues on the inside on my foot - has driven me to tears. Felt that I had been going backwards. However my PT (bless his cotton socks) has had me on mirror therapy to correct my drop foot. Last night, he had me doing another exercise in the mirror that fixes that nerve issue.

[Casper2012]

Smileybeck- what are these mirror exercises your PT has you doing? Can you describe them?

[smilybeck]

Smileybeck- what are these mirror exercises your PT has you doing? Can you describe them?

It's a bit quackish - however works. I was having issues with drop foot which has improved dramatically cause of this (my PT said it should have taken about 5 months to fix last night).

I rest a mirror between my legs - mirror facing my good foot, hiding my bad foot. So what I'm seeing is two awesome looking feet that work properly. From there I do exercises (making sure that I'm copying the exercises on my bad foot) like wiggling the toes, dropping the calf inwards, raising onto my calfs then toes. I do this every night for approx 15 mins.

These new exercises I have been given to correct the nerves. Again rest the mirror between my legs. Hands behind my back, slumbing my shoulders (with my chin in my chest) raise my good foot up, look up, look down, return the leg to the floor. Repeat a few times. Take the mirror away, and repeat with the bad leg. We had done this without the mirror first and my foot was killing me, it's the nerve that runs down the side of the knee. By doing that, it's flushing all the fluid from the nerve.

The main reason we are doing this is I had disassociated my leg from my body - it's a common side effect from people who have experienced traumatic experiences (and severe burns etc) i.e. I had been thinking that this is not my leg, this is not normal. To test if it would work with you is to get a magazine - time yourself on how long it takes to circle the left feet - working back circle the right feet. Words included. You'll find that it's slower to find the bad feet over the good feet.

[c3neely]

http://s1340.photobucket.com/albums/...ps1351f56e.mp4



This is where im at guys. Tibial Plateau Fracture March 2011....plate 6 screws...completely broke the bone off, he had to find it first, and then attach it with the plate

Got my plate out May 30th 2012...microfracture...as well partial meniscus repair

im miserable, but im gonna keep training.

[dnabike]

Hi, I know you are in the NY/NJ area and I hope you have survived the storm without further problems. Please post to let us know you are alright. Up here in Boston the damage was comparatively minor.

Best of luck

Jim.

Recap of my stats:

TPFx, complete mid-shaft fx and fib fx 8/2/12. Bicycling accident.
Surgery 8/8/12, 3 plates & 12 screws.
PWB at 8 weeks, still PWB except for a few TWB steps around kitchen.
58 y/o, single mom of 1 teen daughter, a German shepherd and 2 cats.
Not much in the way of social support structure.
No health insurance; was long term unemployed before accident.
Was extremely active before accident; jogged 10k/day for past 35 years plus daily bicycling,
gardening, frequent hiking, tennis.

Going to PT 2x/week and doing some stretches at home, some use of NuStep recumbent crosstrainer.

Was told flatly that I was lucky to have kept the leg at all and that I'd never jog again
like I used to. Might walk w/permanent limp. and or/cane.

As bad as the physical pain has been, it pales in comparison to the mental/emotional suffering
this injury inflicts. To recent posters c3neely, groycan, didevro-- please know that you
are not alone on this point. c3neely-- I congratulate you on the progress you've made even
to be walking around at all w/o crutches or walker, and that you have a job to walk around at.
All that is still a distant goal for me. Groycan-- I don't have the $$ for counseling but would do it if I could-- this thing is a tsunami to the morale and psyche. Didevro-- my car's a manual trans too and I broke the left leg so I too haven't driven since Aug1. It's pretty scary to be a single mom living in a house w/ a kid-- she is doing all she can to help but has school work too and can't drive, pay bills, etc. No drivers in the house in case of an emergency. . I too found the wheelchair helpful in being about to retrieve and carry things. Also use a walker w/a bicycle basket strapped to te front for carrying.
Had an appt scheduled in NYC tmow morning for a 2nd opinion but had to cancel of course because of the storm.

This is a life-changing event-- no doubt about that. My future is suddenly completely different than I had imagined it up until Aug 2. But on the days when I go to PT and the table next to me has a double amputee, the table behind me has a single amputee and the table in front of me has a stroke victim or a Parkinson's patient.... I imagine their futures are pretty altered from what they once envisioned too. Cherish whatever you can, while you can.

[dnabike]

Hi, just a quick recap of my journey and the importance of a good doctor.

Date of TPF: 5/12/2012 in Orlando Florida
2 days South Lake Hospital, Clermont Fl. $20,000
19 days Orlando Regional Hospital, Orlando FL $320,000
Air lifted to Boston 6/4/2012 $25,000
20 Days Spalding Rehab Hospital - Boston $50,000
Operations: 2 on left leg. 2 plates, 15 screws. There were 9 major pieces and a total of more than 20 pieces.
Other injuries. A/C separation on left shoulder. Required surgery (5.5 hours) and replacement of all ligaments.
NWB 4 months (left leg and left shoulder)
PWB 7 weeks so far
FWB hopefully in 2 weeks.
Complications: Failed to resuscitate after 2nd operation. Result ICU.
Ileus (failure of bowel system). Result Critical Care.

At the first small hospital they kept for 2 days pressing me to let them operate. Finally I got an email to my doctor in Boston who is Senior Orthopedic Surgeon at the Lahey Clinic with 30 years of trauma who explained to them that they were not going operate and instructed them to transfer me to the nearest level one trauma center. He also set me up with supposedly the best in the business at this.

I'm going to put his name out there. Dr. George J. Haidukewych. I don't know whether he can or is in a position to help any of you. I just know he is good. He design some of the hardware used.

Before coming to Orlando he was the head of orthopedic trauma at the Mayo Clinic the 1st or 2nd ranked hospital in the US. I have no idea if he can help any of you, but if you are in bad trouble I would try him. My CAT scan went from Clermont FL, to Boston and back to Orlando, so maybe he could just look at your films. My doctor in Boston says he is the best and doctors in Boston never admit that any one is better than them. He told me that there were only 5-6 doctors in the US that could fix a break as bad as mine. He told me that with all his experience he could not do it, just too difficult.

I am total unqualified to offer any medical advice, but in my opinion a good doctor knows what he can and can't do. I know that Dr. Haidukewych also specializes in fixing TPF's that were not fixed properly. I just get the feeling that a lot of people might have had bad surgery or maybe the injury was just too bad. If yours is not good I would see if his office would give a second opinion.

Anyway my 2 cents about doctors. This is a life altering injury and you need to do everything you can. Good luck and I hope you all survived Sandy.

[dnabike]

Fascinating. I knew they used mirrors on amputees, but this is a new one.

[smilybeck]

I saw that they do this for amputees. I was having so many issues with my foot - it hurt worse than my knee / injury site. The numbness, pins and needles, burning sensations and pinched nerves were holding me back on recovery. Now, my foot is hardly swollen at the end of the day, it's returning to a more normal colour. Also, last night my PT mentioned that I have range of motion in my ankle - just need strength...that's after 3 weeks. Basically, I'm almost ready for FWB - just need sign off from the OS in 2 more weeks.

I found this site while searching for the foot pain that I was having at my darkest moments. Now I want to payforward and share what has worked for me as I was freaking out over the pain. I've been going to a sports PT, one that actually works one of the top rugby league teams in the country. He's really into the manual therapy (ouch) - last night he sat on my foot while he rubbed the bejesus out of the tibial plateau so I couldn't run away.

[ddech]

Go to the ortho at 2 today, Does a TPF surgery normally requier a hospital stay. Or can they do it out patient? Broke last Saturday playing soccer with the kids.

[kmrrdb]

ddech, yes I was in hospital for 3 days. Most Dr will want to either monitor pain or signs of infection. I had a nerve block on my leg following surgery which lasted about 30 hours, so that may be the reason I was there that long. I liked the nerve block as it made my 1st day after surgery easier with less meds. My surgery was 8/31/12 and I now have 4 screws and 1 plate. I am 9 weeks out from TPF surgery and am still on crutches but can put up to 25lbs on my leg and its starting to feel more normal every day. Long process but it gets better.

[crystalteras]

So I am a lil over 5 months post op.
TPF-type 6 with depression

I am now able to flex my knee at 135* as of yesterday.

Now I was just wondering what everyone else is at. My pt tells me that that is about a very normal flexion but I can't still do things I could before. Now my pt says that my other knee is extremely flexible so he said it probably won't get back to what my other leg is but I really am trying. Not giving up. Just thought I'd see...

[dnabike]

I'm 6 months post surgery and I'm at 121 degrees. Still 10 days from FWB. I think 135 is great would like to get there myself.

Sent from my Lumia 900 using Board Express

[skiplct]

Greetings-- Back on line after a 5 day power outage due to Hurricane Sandy. If there's anything less fun than being a TPFx patient, it's being a TPFx patient w/no heat or electricity..... Seriously-- this injury gives one a whole new perspective on these challenges. My child and dog and I spent 4 nights out of the house in various places to keep warm; lost a piece of our roof, but had no basement flooding and fire like we did after Irene so it wasn't too bad. I'm taking NWB steps around the house now and then; also changing around between 2 crutches, 1 crutch and cane. Trnasition to cane is hard on the hand, guys!-- be prepared by getting some sturdy foam rubber to tape around the cane handle. One crutch was easier because there were 2 points of weight distribution (armpit and hand), and both are padded. Still losts of pain in the knee, tibial shaft (where I had complete longitude and latitude fx's), and discomfort in the ankle/foot. Going to try out that cool mirror trick tonight.

Thanks to all who post here-- this message board was one of the things I missed most about losing power-- much more than TV!-- but not as much as heat and lights...